Provider Demographics
NPI:1164401360
Name:BUTTS, JAMES A JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:BUTTS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-535-7445
Practice Address - Street 1:725 JESSE JEWELL PKWY SE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3834
Practice Address - Country:US
Practice Address - Phone:770-536-2323
Practice Address - Fax:770-536-4947
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036508208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000075578DMedicaid
GA1281400OtherCIGNA
GA1707016OtherUNITED HEALTHCARE
GA000075578EMedicaid
GA20030423OtherRR MEDICARE-GRP # CC4177
GA52451285OtherBCBS
GA4567385OtherAETNA
GA10045148OtherAMERIGROUP
GA340823OtherWELLCARE
GA340823OtherWELLCARE
02BDGSRMedicare ID - Type Unspecified